For a while there, it looked like diabetes was going to win. He's a stubborn sonofabitch with a wicked nasty sense of humour sometimes.
Luckily, so am I.
Here's how it went.
Last night, I was working until four pm and I wanted to have my running shoes on and be out the door for my 9k run by 4:15pm.
The pre-run planning started at 2:30pm.
I lowered my basal rate to 50% like I always do for my afternoon runs.
I checked my sugar to make sure it was falling back down nicely after my 12pm lunch.
It was 15.6.
Damn. I didn't want to take my full correction dose because I was running in less than two hours. But I couldn't stay that high for another 90 minutes. I took half of the suggested correction dose and crossed my fingers.
At 3pm I was 16.
At 3:30pm I was 17.
I prefer a subtle approach to my diabetes management. I try not to take too much insulin because I hate the roller coaster that often follows. Instead of rage bolusing, I tend to baby bolus. Little boluses with frequent checks to see what's happening.
My baby bolus approach wasn't working and my running time was fast approaching...and I wanted to run dammit. So I took a full correction dose at 3:30pm despite my impending run.
At 4pm, I was 16.9. No drop yet but at least I had stopped climbing.
I was faced with two options:
1. Don't run. That, my friends, would be the sensible option. That is probably what the doctor would tell me to do and is probably what you should do when your blood sugar has been high for a few hours for no apparent reason and you have several unit of insulin floating around your system, just waiting for something (like a run) to kick start them into action. Exercise, with high blood sugar, can be pretty risky. With too much insulin in the system, running could cause it to drop like a stone. Or, the insulin could continue to be ineffective and the exercise can cause the blood sugar to climb. If it climbs, that it very very bad, and very very dangerous. Ketones can start being produced as your body starts breaking down fat for energy because it can't access the glucose it needs. Ketoacidosis is the next step and that is dangerous at best and fatal at worst.
2. Run. Take a risk. Take a chance that the exercise will cause my blood sugar to drop. Of course, if it drops too much, we're in an even more, and immediate, dangerous situation.
I decided to try to arm wrestle the diabetes demons into submission.
Of course I had no idea which one of these arms wrestlers was going to be me and which one was going to be the demon. But I had a hunch and diabetes management is as much about instinct and witchcraft as it is about science and predictability so I went with my hunch.
I headed out with a blood sugar of 16.9 and 3 units of insulin in my system.
I ran 9k (in 53 minutes thank you very much).
I made it home alive, in one piece and feeling better than when I left.
My blood sugar? 5.2
Running dropped me from 16.9 to 5.2 in 53 minutes.
I poured myself a cup of chocolate milk and sipped it while I stretched figuring my sugar was going to keep dropping but not wanting to spike it back up again. An hour later, I was 9.0 and ready for dinner.
I will never win the war but it's sure nice to win a battle every once in a while.